Roles of electrical impedance tomography in lung transplantation

Jiang, Hui; Han, Yijiao; Zheng, Xia; Fang, Qiang

doi:10.3389/fphys.2022.986422

Cited by 3 publications

(1 citation statement)

References 117 publications

(140 reference statements)

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“…Electrical impedance tomography (EIT) is a functional imaging tool that can be used to evaluate pulmonary ventilation and perfusion. Due to its portable size, dynamic imaging ability, and the lack of need for radiation, EIT may be suitable for bedside monitoring in mechanically ventilated patients after lung transplantation ( 6 ). Moreover, it is a novel imaging technique that allows real-time detection of pendelluft ( 5 ).…”

Section: Introductionmentioning

confidence: 99%

Evaluating bronchial anastomotic stenosis dynamically by electrical impedance tomography in a lung transplant recipient: a case report

Jiang¹,

Han²,

He³

et al. 2023

Ann Transl Med

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Background: Lung transplantation has become the first-choice treatment method for end-stage pulmonary disease patients. However, various postoperative airway complications hinder the progress of lung transplantation, with the most frequently reported complication being bronchial stenosis. Pendelluft is an intrapulmonary air redistribution in areas with different time constants and this phenomenon is largely unobservable. Meanwhile, pendelluft is the movement of gas in the lung without a change in tidal volume and can contribute to injury by introducing regional overdistension and tidal recruitment. Electrical impedance tomography (EIT) is a radiation-free and noninvasive imaging tool that can be used to evaluate pulmonary ventilation and perfusion. EIT is also a novel imaging technique that allows real-time detection of pendelluft.Case Description: A single lung transplant recipient had bronchial anastomotic stenosis caused by necrosis. The patient was admitted to the intensive care unit for the second time due to worsening oxygenation. We evaluated the patient's pulmonary ventilation and perfusion and pendelluft effect dynamically by EIT. The saline bolus injection method was used to evaluate pulmonary perfusion distribution. We removed the bronchial anastomosis necrosis using bronchoscopy biopsy forceps. The ventilation/perfusion (V/Q) matching in the transplanted lung improved compared to that before necrosis removal. After necrosis removal, the global pendelluft in the lung transplant recipient improved.Conclusions: EIT can be used to quantitatively evaluate the pendelluft and V/Q matching due to bronchial stenosis in lung transplantation. This case also demonstrated the potential of EIT as a dynamic pulmonary functional imaging tool for lung transplantation.

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Section: Introductionmentioning

confidence: 99%

Evaluating bronchial anastomotic stenosis dynamically by electrical impedance tomography in a lung transplant recipient: a case report

Jiang¹,

Han²,

He³

et al. 2023

Ann Transl Med

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Technical Principles and Clinical Applications of Electrical Impedance Tomography in Pulmonary Monitoring

Cui,

Liu,

et al. 2024

Sensors

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Pulmonary monitoring is crucial for the diagnosis and management of respiratory conditions, especially after the epidemic of coronavirus disease. Electrical impedance tomography (EIT) is an alternative non-radioactive tomographic imaging tool for monitoring pulmonary conditions. This review proffers the current EIT technical principles and applications on pulmonary monitoring, which gives a comprehensive summary of EIT applied on the chest and encourages its extensive usage to clinical physicians. The technical principles involving EIT instrumentations and image reconstruction algorithms are explained in detail, and the conditional selection is recommended based on clinical application scenarios. For applications, specifically, the monitoring of ventilation/perfusion (V/Q) is one of the most developed EIT applications. The matching correlation of V/Q could indicate many pulmonary diseases, e.g., the acute respiratory distress syndrome, pneumothorax, pulmonary embolism, and pulmonary edema. Several recently emerging applications like lung transplantation are also briefly introduced as supplementary applications that have potential and are about to be developed in the future. In addition, the limitations, disadvantages, and developing trends of EIT are discussed, indicating that EIT will still be in a long-term development stage before large-scale clinical applications.

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Fatal Infections Differentially Involve Allograft and Native Lungs in Single Lung Transplant Recipients

Villalba,

Cheek-Norgan,

Johnson

et al. 2023

Archives of Pathology &Amp; Laboratory Medicine

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Context.— Respiratory infections complicate lung transplantation and increase the risk of allograft dysfunction. Allograft lungs may have different susceptibilities to infection than native lungs, potentially leading to different disease severity in lungs of single lung transplant recipients (SLTRs). Objective.— To study whether infections affect allograft and native lungs differently in SLTRs but similarly in double LTRs (DLTRs). Design.— Using an institutional database of LTRs, medical records were searched, chest computed tomography studies were systematically reviewed, and histopathologic features were recorded per lung lobe and graded semiquantitatively. A multilobar-histopathology score (MLHS) including histopathologic data from each lung and a bilateral ratio (MLHSratio) comparing histopathologies between both lungs were calculated in SLTRs and compared to DLTRs. Results.— Six SLTRs died of infection involving the lungs. All allografts showed multifocal histopathologic evidence of infection, but at least 1 lobe of the native lung was uninvolved. In all 5 DLTRs except 1, histopathologic evidence of infection was seen in all lung lobes. On computed tomography, multifocal ground-glass and/or nodular opacities were found in a bilateral distribution in all DLTRs but in only 2 of 6 SLTRs. In SLTRs, the MLHSAllograft was higher than MLHSNative (P = .02). The MLHSratio values of SLTR and DLTR were significantly different (P < .001). Conclusions.— Allograft and native lungs appear to harbor different susceptibilities to infections. The results are important for the management of LTRs.

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Roles of electrical impedance tomography in lung transplantation

Cited by 3 publications

References 117 publications

Evaluating bronchial anastomotic stenosis dynamically by electrical impedance tomography in a lung transplant recipient: a case report

Evaluating bronchial anastomotic stenosis dynamically by electrical impedance tomography in a lung transplant recipient: a case report

Technical Principles and Clinical Applications of Electrical Impedance Tomography in Pulmonary Monitoring

Fatal Infections Differentially Involve Allograft and Native Lungs in Single Lung Transplant Recipients

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